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Depression in Schizophrenia: Pathophysiological Mechanisms and Therapeutic Approaches

Rukavishnikov G.V., Mazo G.E.
Federal governmental budget institution «National medical research center of psychiatry and neurology n.a. V.M. Bekhterev» Ministry of Health of Russian Federation

Summary: Depression is a common phenomenon in the structure of schizophrenia. Depression in schizophrenia is associated with worse disease course, lower quality of life and suicidal behavior. However the data on the comorbidity of depression and schizophrenia is very variable due to different diagnostic and methodological issues in evaluation of their interactions. In our review we analyzed the recent data on pathophysiological mechanisms and therapeutic approaches to depression in patients with schizophrenia. According to recent research the main mechanisms of interaction between depression and psychotic disorders are inflammatory process and complex hormonal/metabolic disturbances. Due to the lack of evidence-based data on antidepressant treatment efficacy, one of the key aims of the therapy of depression in schizophrenia is the choice of antipsychotic with significant antidepressant potential but with minimal risks of metabolic side-effects.

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